Based on Miscellaneous Disease Origin Rhino Candle, this paper explores the academic thought and medication characteristics of Shen Jin 'ao, a member of Longsha Medical School, in treating depression
基于《杂病源流犀烛》浅探龙砂医派沈金鳌治郁学术思想与用药特色

摘要

本文结合《杂病源流犀烛》相关内容，从病机、诊法、治疗三方面系统梳理龙砂医派清代代表医家沈金鳌治疗郁证的学术思想与用药特色。沈氏以“脏气虚损为本，气血郁滞为标”为核心病机，强调情志、饮食等外因须借脏腑内虚致病，久郁可化生痰、湿、瘀等变证。诊法注重脉症合参，以沉伏、促结之脉为郁证特征，痞满、刺痛等症可定位郁结层次。治疗上，沈氏以《内经》五郁理论为基础，构建“因势利导，分郁论治”的诊疗体系，针对气、血、痰、火、湿、食等不同郁结类型，分别确立疏宣、通达、化痰、清泄、渗利、消导等具体治法。其用药忌酸敛滞腻，善用香附、陈皮、川芎等理气散结之品，体现了理法方药的系统性与临床实用性。

Abstract

Based on the related content of Miscellaneous Disease Origin Rhinoceros Candle, this paper systematically combs the academic thoughts and medication characteristics of Shen Jinao, a representative doctor of Longsha Medical School in the Qing Dynasty, in the treatment of depression from three aspects : pathogenesis, diagnosis and treatment. Shen 's core pathogenesis is ' viscera qi deficiency is the root cause, qi and blood stagnation is the symptom ', emphasizing that external causes such as emotion and diet must be caused by internal deficiency of viscera, and long-term depression can produce phlegm, dampness, blood stasis and other changes. The diagnosis method pays attention to the combination of pulse symptoms, and takes the pulse of sinking and promoting knot as the characteristics of depression. The symptoms such as fullness and tingling can locate the level of depression. In terms of treatment, based on the theory of five depressions in Neijing, Shen constructed a diagnosis and treatment system of ' making the best use of the situation and treating depression by differentiation '. In view of different types of depression such as qi, blood, phlegm, fire, dampness and food, he established specific treatment methods such as dredging, dredging, resolving phlegm, clearing, infiltrating and eliminating. Its medication avoids acid stagnation and greasy, and makes good use of Xiangfu, Chenpi, Chuanxiong and other qi-regulating and stasis-dispersing products, reflecting the systematic and clinical practicability of the prescription.